[Endoscopic-radiological demonstration of the gastrointestinal lymph nodes and lymph vessels]

Using an intragastric contrast medium (Lipiodol) the paragastric lymph nodes of 23 patients were lymphangiographed prior to laparotomy. The patients suffered from gastric or duodenal ulcers (15 cases), postresectional ulcers (3 cases), or gastric carcinoma (5 cases). The surgically resected material was examined by radiological and histological techniques. The following results were obtained: 1. After application of the contrast medium the paragastric lymph nodes could firstly be seen 5 hours later and even after 7 days and more. 2. The radiographs presented typical storage phenomena with granular or clod-like structures as an equivalent of the inflammatory lymph node alterations. Histologically a marked sinus catarrh with lipid laden reticulum cells and multinuclear giant cells of the foreign body types was observed. 3. In gastric carcinoma characteristic storage defects up to complete destruction of the lymph nodes were found as a roentgenological equivalent of lymph nodes metastases. In addition there were occasionally abnormal courses of the lymphatic vessels with variations in diameter and bizarre storage formations. 4. The described method provides a helpful tool in the diagnosis of gastric lesions. No side effects have been observed.